Concerns about and stimuli of COVID-19 vaccination hesitancy among diverse occupational groups in metropolitan areas of China: a cross-sectional study.

OBJECTIVES: In this study, we aimed to identify concerns and stimuli regarding COVID-19 vaccination acceptance and to compare the findings by occupation. METHODS: We conducted a cross-sectional study of individuals vaccinated against COVID-19 between 1 April and 30 June 2021 in four metropolitan areas of China. A total of 20 863 participants completed questionnaires, 20 767 of which were eligible for analysis. We used ordered logistic regression to assess the association of vaccination concerns and stimuli with vaccination hesitancy according to occupation. RESULTS: Farmers were mainly concerned about the quality of vaccines (adjusted OR (aOR): 3.18, 95% CI (CI): 1.83 to 5.54). Among civil servants, media publicity reduced hesitancy (aOR: 0.44, 95% CI: 0.21 to 0.92). Among medical staff, concerns about a short duration of protective effects increased hesitancy (aOR: 8.31, 95% CI: 2.03 to 33.99). For most occupations, concerns about side effects, poor protective effects and health status increased hesitancy. In contrast, protecting oneself and protecting others acted as a stimulus to decrease hesitancy. Interestingly, 'people around me have been vaccinated' was associated with higher vaccination hesitancy among farmers (aOR: 2.19, 95% CI: 1.20 to 4.00). CONCLUSION: The association of vaccination concerns and stimuli with vaccination hesitancy varied by occupation. The characteristics and concerns of specific target audiences should be considered when designing informational campaigns to promote vaccination against COVID-19.

Accelerate the process of getting vaccinated: factors associated with consideration of and accessibility to COVID-19 vaccination in metropolises of China.

BACKGROUND: Rapid mutation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is sweeping the world and delaying the full reopening of society. Acceleration of the vaccination process may be the key element in winning the race against this virus. We examine factors associated with personal considerations of and accessibility to the corona virus disease 2019 (COVID-19) vaccination in metropolises of China. METHODS: This multi-center, cross-sectional research was conducted using online questionnaires from April 1 to June 1, 2021, in community health service centers of Shanghai, Chengdu and Fuzhou. 9,047 vaccinated participants were included and data for 8,990 individuals were eligible for analysis. Chi-square test was conducted to find potential predictors, which were included in the logistic regressions. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the influence of region, socio-economic status (SES), and attitudes on vaccination process. RESULTS: In consideration phase, participants in Fuzhou (OR:2.26, 95%CI: 1.90 to 2.68) and Chengdu (OR: 2.48, 95%CI: 2.17 to 2.83) were more likely than those in Shanghai to consider longer than one month. These odds increased for participants with master or above degree (reference: illiteracy and primary school), higher monthly household income (reference: < ¥5000), and greater vaccination hesitancy (reference: low hesitancy). Unemployed and household-based participants (OR: 3.37, 95%CI: 1.69 to 6.75, reference: farmer) and participants without brand preference (OR:1.13, 95%CI:1.02 to 1.26) may take longer time of consideration. In the accessibility phase, participants in Fuzhou (OR: 8.82, 95%CI: 7.28 to 10.68) and Chengdu (OR: 2.28, 95%CI: 1.98 to 2.63) were more likely to wait longer than one week. These odds decreased for participants with master or above degree (reference: illiteracy and primary school), monthly household income from ¥5000 to ¥10,000 (reference: < ¥5000), and teacher or student (reference: farmer). Participants without brand preference (OR: 0.86, 95%CI: 0.77 to 0.95) were likely to wait shorter after appointment, while participants with higher risk awareness of domestic epidemic (medium, OR: 1.24, 95%CI: 1.12 to 1.37, reference: low) may wait longer. CONCLUSIONS: The influential factors changed over two phases of vaccination process. Regional disparity affected both consideration and accessibility phases. Expect that, SES, and hesitancy were major factors of the consideration phase, but had limited impact on accessibility phase.